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Trial registered on ANZCTR
Registration number
ACTRN12610000180011
Ethics application status
Approved
Date submitted
22/02/2010
Date registered
1/03/2010
Date last updated
1/03/2010
Type of registration
Retrospectively registered
Titles & IDs
Public title
Efficacy of Pleurodesis When Accumulation of Fluids occurs in Fetal Lungs
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Scientific title
Efficacy of antenatal OK-432 Pleurodesis in Bilateral Pleural Effusion as assessed by neonatal survival rates
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Universal Trial Number (UTN)
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Trial acronym
OK432
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Fetal Bilateral Pleural Effusion
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Condition category
Condition code
Reproductive Health and Childbirth
257014
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0
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Fetal medicine and complications of pregnancy
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
diet modification (by using medium-chain triglyceride oil exclusively when cooking), followed by amniocentesis (performed at GA 16 weeks or later with ultrasound guidance under aseptic precautions) to exclude aneuploidy, followed by thoracocentesis (using a 21 gauge needle to pierce into fetal chest under ultrasound guidance under aspetic precautions), and finally OK-432 pleurodesis (a dosage of 0.1~0.5KE OK-432 per side was used after thoracocentesis to drain dry the pleural fluids and will be repeated two weeks later if pleural effusions recur, a maximun of three treatments will be adopted).
The duration of amniocentesis itself (we only calculate the duration when the needle is in the amniotic cavity) is less than 30 seconds. The duration of thoracocentesis will be longer since we need to aspirate all the pleural fluids and it usually took less than 3 minutes. The duration of OK-432 pleurodesis is the sum of the duration of thoracocentesis plus the duration of instillating the medication. The time cost in unilateral pleurodesis is usually less than 5 minutes, and thus the duration of bilateral pleurodesis is less than 10 minutes. Gestation ages of the fetuses ranged from GA(gestational age) 16 weeks to 29 weeks.
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Intervention code [1]
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Treatment: Other
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Intervention code [2]
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Treatment: Drugs
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Intervention code [3]
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Treatment: Surgery
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Comparator / control treatment
Nil
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Intrauterine death or livebirth but neonatal death or survival beyond the newborn stage
--by data linkage to medical records
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Assessment method [1]
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Timepoint [1]
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when pregnancy is terminated, either due to fetal death, or for livebirth delivery; and at age 1 month
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Secondary outcome [1]
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responses include poor response, partial response, or total remission
Poor response is defined as progression or no improvement of disease. Partial response is defined as lessening of severity of disease but not complete remission. Total remission means disappearance of pleural effusion.
The main tool used for evalutaion is ultrasound.
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Assessment method [1]
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Timepoint [1]
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two weeks after OK-432 pleurodesis and will be followed fortnightly until end outcome occurs, including livebirths, delivery of dead fetus, or termination of the pregnancy with alive fetus before GA 24 weeks.
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Eligibility
Key inclusion criteria
Fetal Bilateral Pleural Effusions
(onset at any gestational period)
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Minimum age
No limit
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Those with abnormal karyotype ascertained by amniocentesis or other invasive methods
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
fetuses with bilateral pleural effusions are enrolled initially. They were given diet modification first for one week, then those without response would receive amniocentesis; after the karyotype was availabe after one week, those with normal karyotype would receive thoracocentesis; and only those with lymphocyte-rich pleural fluids would enter the treatment group if no spontaneous remission occurred. OK-432 pleurodesis would be performed in the treatment group and the fetuses would be followed up fortnightly.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
NA
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 0
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/05/2005
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
40
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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Taiwan, Province Of China
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State/province [1]
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Changhua Christian Hospital
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Address [1]
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135, Nanhsiao street, Changhua Christian Hospital Medical Center (JCI-accredited), Changhua 500
JCI is an organization based in Chicago which is dealing with hospital accreditation and receives interntaional request to accreditate worldwide health organizations. JCI is the abbreviation of Joint Commissions International
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Country [1]
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Taiwan, Province Of China
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Primary sponsor type
Government body
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Name
National Science Council
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Address
106, Sec. 2, Heping E. Rd., Taipei City 10622, Taiwan (R.O.C.)
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Country
Taiwan, Province Of China
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Secondary sponsor category [1]
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Hospital
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Name [1]
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National Taiwan University Hospital
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Address [1]
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No.1, Chang-Te Street, Taipei City 10048
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Country [1]
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Taiwan, Province Of China
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Other collaborator category [1]
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Hospital
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Name [1]
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Mackay Memorial Hospital
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Address [1]
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No. 92, Sec.2, Zhongshan N. Rd., Taipei City 10449
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Country [1]
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Taiwan, Province Of China
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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The Institution Review Board, Changhua Christian Hospital (CCH-IRB)
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Ethics committee address [1]
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No. 135, Nanhsiao Street, Changhua City, 500
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Ethics committee country [1]
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Taiwan, Province Of China
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Date submitted for ethics approval [1]
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09/12/2004
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Approval date [1]
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01/04/2005
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Ethics approval number [1]
258599
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Summary
Brief summary
We wished to set up the efficacy and safety data of applying OK-432 pleurodesis in human fetuses afflicted with bilateral chylothorax and followed up their outcomes as well as if there are any maternal complications.
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Trial website
N/A
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Trial related presentations / publications
Chen M, Shih JC, Wang BT, Chen CP, Yu CL. 2005. Fetal OK-432 pleurodesis: complete or incomplete? Ultrasound Obstet Gynecol 26: 791-793. Chen M, Hsieh CY, Shih JC, Chou CH, Ma GC, Chen TH, Lee TH, Tsai HD, Cameron AD, Chen CP. 2007. Proinflammatory macrophage migratory inhibition factor and interleukin-6 are concentrated in pleural effusion of human fetuses with prenatal chylothorax. Prenat Diagn 27: 435-41. Chen CH, Chen TH, Kuo SJ, Chen CP, Lee DJ, Ke YY, Yeh KT, Ma GC, Liu CS, Shih JC, Chen M. 2009. Genetic evaluation and management of fetal chylothorax: review and insights from a case of Noonan syndrome. Lymphology 42: 134-138. Ma GC, Liu CS, Chang SP, Yeh KT, Ke YY, Chen TH, Wang BB, Kuo SJ, Shih JC, Chen M. 2008. A recurrent ITGA9 missense mutation in human fetuses with severe chylothorax: possible correlation with poor response to fetal therapy. Prenat Diagn 28: 1057-1063.
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Ming Chen, MD, PhD
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Address
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Department of Genomic Medicine,
Changhua Christian Hospital Medical Center,
No.176, Chunghua Rd., 3F, Changhua City 500
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Country
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Taiwan, Province Of China
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Phone
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+886-4-7225121 ext 2323
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Fax
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+886-4-7249847
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Email
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[email protected]
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Contact person for scientific queries
Name
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Ming Chen, MD, PhD
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Address
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Department of Genomic Medicine,
Changhua Christian Hospital Medical Center,
No.176, Chunghua Rd., 3F, Changhua City 500
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Country
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Taiwan, Province Of China
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Phone
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+886-4-7225121 ext 2323
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Fax
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+886-4-7249847
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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